胃不同部位病理活组织组合反映胃黏膜病变的研究  

Effect of Different Pathological Tissue Combinations on Gastric Mucosal Disease under Gastroscopy

作　　者：宫健康 谢发平[1,2] 池堂春 Gong Jiankang;Xie Faping;Chi Tangehun(Chuzhou Clinical Hospital of Anhui Medical University,Chuzhou 239000,China;The First People＇s Hospital in Chuzhou City,Chuzhou 239000,China)

机构地区：[1]安徽医科大学滁州临床学院,安徽滁州239000 [2]滁州市第一人民医院,安徽滁州239000

出　　处：《北华大学学报（自然科学版）》2018年第5期654-656,共3页Journal of Beihua University（Natural Science）

基　　金：安徽省卫生科技计划项目(2013NS0081)

摘　　要：目的探讨胃镜下不同病理活组织组合反映胃黏膜病情的效果.方法收集行无痛胃镜检查的536例患者,依据修订版悉尼系统标准中建议的采集胃体大弯(A1)、小弯(A2)、胃角(B1)、胃窦大弯(C1)、小弯(C2)5个部位的病理组织,参照胃炎评价标准(OLGA)和胃黏膜肠化生评价标准(OLGIM)进行分期.分析4处、3处、2处病理组织的不同组合方式与5处病理组织评价准确性的一致性.结果胃窦小弯黏膜萎缩及肠化生发生率明显高于胃窦大弯、胃体小弯和大弯,差异具有统计学意义(P<0.05);胃角黏膜萎缩及肠化生明显高于胃体小弯和大弯,差异具有统计学意义(P<0.05);胃体小弯、胃窦大弯黏膜萎缩及肠化生明显高于胃体大弯,差异具有统计学意义(P<0.05).与5处病理组织活检在OLGA,OLGIM分期一致性最高的4处病理组织活检组合为胃体小弯、胃角、胃窦大弯和小弯组合,一致性为99.0%,98.1%;3处病理组织活检组合为胃体小弯、胃角、胃窦小弯组合,一致性为93.5%,93.1%;2处病理组织活检组合为胃体小弯、胃窦小弯组合,一致性为77.9%,77.5%.结论胃体小弯、胃角、胃窦小弯3处病理组织活检组合能够以较少的取材较为准确地反映胃黏膜病变情况,值得临床参考.Objective To explore the effect of different pathological tissue combinations on gastric mucosal disease under gastroscopy. Method The patients with painless gastroscopy were collected. According to the revised Sydney system standard,the pathological tissue of 5 parts of the stomach body（ A1）,small bend（ A2）,B1,C1 and small bend（ C2） were collected,and the standard of gastritis evaluation（ OLGA） and gastric sticky were referred. The criteria for the evaluation of intestinal metaplasia（ OLGIM） were staging. The consistency of different combinations of 4,3 and 2 pathological tissues with 5 pathological tissues was analyzed. Results The incidence of atrophy and intestinal metaplasia of the gastric antrum was significantly higher than that of the great bend of the gastric antrum,the small bend of the stomach and the big bend（ P〈0.05）. The atrophy and intestinal metaplasia of the gastric antrum were significantly higher than that of the small bends and large curves of the stomach（ P〈0.05）; the small bend of the stomach,the atrophy of the mucosa and the intestinal metaplasia in the large bend of the gastric antrum. There was significant difference in gastric curvature（ P〈0.05）. 4 pathological tissue biopsy combined with5 pathological tissue biopsy in OLGA and OLGIM staging was the combination of gastric antral small bend,stomach angle,gastric antrum big bend and small bend. The consistency was 99. 0% and 98. 1%. 3 pathological tissue biopsy combinations were small bend of gastric antrum,stomach angle and gastric antrum,the consistency was 93.5%,93. 1%,and 2 pathological tissue biopsy group consisted of lesser curvature of gastric antrum and lessercurvature of gastric antrum,with a consistency of 77. 9% and 77. 5%. Conclusion The 3 pathological tissue biopsy combinations of gastric antrum,stomach angle and gastric antrum can reflect the pathological changes of gastric mucosa more accurately,which is worthy of clinical reference.

关 键 词：胃体小弯 胃黏膜病变 活检部位 胃炎评价标准 胃黏膜肠化生 评价标准 

分 类 号：R573[医药卫生—消化系统]